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Brief Treatment Approaches for Addressing Chronic Pain in Primary Care Settings
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Physical deconditioning refers to the atrophy and stiffening of muscles, bones, and connective tissue that is likely to result from inactivity due to pain. If the body is viewed as a “kinetic chain” of muscles and bones that all support one another, then maintaining a healthy musculoskeletal system can help support physical “weak links” in the kinetic chain that cause or contribute to pain and disability. To overcome this, the psychologist in primary care can work closely with the PCP to establish an exercise plan using gradual pacing of activity and oriented toward a functional goal of meaningful activity for the patient (e.g., spending more time with family, working longer without needing a break due to pain). Interestingly, exercise programs that emphasize strength may be more effective for pain outcomes than those emphasizing cardiorespiratory health (Searle, Spink, Ho, & Chuter, 2015).
Dementia and physical health
Published in Graham A. Jackson, Debbie Tolson, Textbook of Dementia Care, 2019
Older people are more prone to the complications of disease. The risk is increased across multiple domains such as adverse drug reactions, surgical wound infections, delirium, malnutrition, falls, pressure sores, venous thrombo-embolism, hospital acquired infections, constipation and deconditioning.
Fatigue
Published in Margaret O’Connor, Sanchia Aranda, Susie Wilkinson, Palliative Care Nursing, 2018
Winningham (1999), an exercise physiologist and a registered nurse, focused her theory of fatigue on the ‘deconditioning effect’ of serious illness, its multiple symptoms, and its treatment. This ‘deconditioning effect’ was a result of patients reducing their activity levels when they became ill. Winningham suggested that a balance between rest and activity was needed to prevent spiralling loss of physical function in cancer patients. This model works particularly well when testing exercise and activity for prevention of fatigue (see Box, page 146).
Supine arm cycling during the post-flap recovery period for persons with spinal cord injuries: The multi-purpose arm cycle ergometer (M-PACE) safety and pilot testing
Published in The Journal of Spinal Cord Medicine, 2023
Christine M. Olney, John E. Ferguson, Greg Voss, Eric Nickel, Stuart Fairhurst, Alexandra S. Bornstein, Sara Kemmer, Crystal Stien, Kristin Scheel, Charlotte Brenteson, Ann Goding, Mary Murphy Kruse, Byron Eddy, Gary Goldish, Andrew H. Hansen
The 6MAT data tell us that there may be some beneficial conditioning effects of performing arm cycling while on bedrest. Though there are not enough data to determine dosage needed to make a difference, 14 of 15 participants either maintained or improved their conditioning per reported RPE during their bedrest. This alone, is interesting because we have known for a long time the detrimental effects of prolonged bed rest, including deconditioning.1,2 Yet, with exercise in this study we were able to show that stopping deconditioning and even reconditioning is possible in this population during the post-flap recovery period. In addition to reduced RPE, many subjects produced more rotations of the arm crank during the 6MAT (P = 0.02), suggesting they did more work with less perceived exertion. Ideally, the number of rotations would be kept constant between pre- and post-conditions. Both changes, the RPE and the number of rotations, suggest reductions in deconditioning.
Enhancing Health-Related Quality of Life through Occupational Therapy: A Case Report of a Client with Postural Orthostatic Tachycardia Syndrome
Published in Occupational Therapy In Health Care, 2022
POTS is characterized by an unusual increase in heart rate: greater than or equal to 30 beats per minute (greater than or equal to 40 beats per minute in children and adolescents) within 10 minutes of assuming an upright position (Stewart, 2013). Other symptoms that individuals with POTS may experience upon standing include shortness of breath, dizziness, lightheadedness, extreme fatigue, pre-syncope, syncope, exercise intolerance, tremors, headache, and brain fog (Grubb et al., 2006). Attention deficits, thermodysregulation, sleep disturbances, and gastrointestinal disturbances can also be experienced, regardless of body position (Grubb et al., 2006; Raj, 2006; Stewart, 2013). For diagnosis, symptoms cannot be solely attributed to deconditioning, and must persist for more than three months (Raj, 2006). It should be noted that deconditioning often occurs due to decreased engagement in activities of daily living.
The impact of mental toughness and postural abnormalities on dysfunctional breathing in athletes
Published in Journal of Asthma, 2022
Justin Greiwe, Jae Gruenke, Joanna S. Zeiger
Dysfunctional breathing may present alone, in conjunction with an underlying disease, or as a somatic manifestation of a psychological condition. When DB occurs when there is co-existent respiratory disease, it is difficult to determine which disorder is contributing to the reported symptoms. The differential diagnosis of DB is extensive and requires a comprehensive clinical history and appropriate testing to rule out other disorders. Various conditions mimic DB, with asthma and EIB being the most common culprits. Due to the close association between asthma and DB, it is important to identify asthma and optimize treatment before settling on the diagnosis of DB. Dysfunctional breathing is a diagnosis of exclusion, therefore organic diseases must first be excluded or adequately treated before DB can be considered. Dysfunctional breathing patterns can occur in patients with various disease states summarized in Table 1 (9,10). Simple deconditioning as well as psychological factors should also be considered, especially if objective testing does not reveal a diagnosis. Panic and anxiety related disorders are often linked to DB, especially HVS, but can also be seen in other respiratory conditions like asthma as well (11). Given the complexity of these psychological disorders, it is often difficult to assess whether HVS is causative or simply a secondary effect experienced by the patient.